Hospital Acquired Infections SDL

Hospital-acquired infection (HAI)

infection developing 48–72 hours after hospital admission

Another name for hospital-acquired infection

nosocomial infection

Most hospital-acquired infections

UTI, surgical/wound infection, lower resp tract infection, bacteremia, infected burns

Most common UTI pathogen in HAI

Escherichia coli

Other common HAI UTI pathogens

Candida albicans, Enterococci, and Staphylococci

Major risk factor for hospital-acquired UTI

urinary catheterization

Route of infection in most hospital-acquired UTIs

ascending infection

ESBL-producing organism commonly causing HAI UTI

Klebsiella pneumoniae

Main pathogens in surgical site infections

Enterococci and coagulase-negative staphylococci

Classic signs of surgical wound infection

redness, swelling, pain, heat, and purulent discharge

Predisposing factors for respiratory tract HAI

anaesthesia and mechanical ventilation

Common pathogens in ventilator-associated pneumonia

Staphylococcus aureus and Pseudomonas aeruginosa

Ventilator-associated pneumonia (VAP)

pneumonia associated with mechanical ventilation

Common bacteremia pathogens in HAI

Staphylococcus epidermidis and Staphylococcus aureus

Major cause of catheter-related bacteremia

sutures and indwelling catheters

Primary bacteremia

direct introduction of organisms into blood

Secondary bacteremia

spread to blood from another infection site

Important antibiotic-resistant HAI pathogen

MRSA

Most common pathogen in infected burns

Pseudomonas aeruginosa

MRSA stands for

methicillin-resistant Staphylococcus aureus

Acinetobacter baumannii

emerging HAI pathogen from skin flora

Legionella pneumophila causes

hospital-acquired respiratory infection

Blood-borne viruses linked to HAI

Hepatitis B, Hepatitis C, HIV, and CMV

Airborne transmission occurs through

talking, coughing, sneezing, aerosols, and skin shedding

Gram-negative bacteria survive best

in humid environments

Direct contact transmission

person-to-person spread

Indirect contact transmission

spread through contaminated hands or equipment

Hospital staff hands and clothing

important vectors of HAI transmission

Food-borne HAI may originate from

contaminated hospital kitchen or feeds

Blood-borne HAI transmission commonly occurs via

needle-stick injuries

Self-infection

infection from patient’s own flora

Cross-infection

infection transmitted from another patient or staff

Main cause of cross-infection

hospital strains such as MRSA

Major risk factors for HAI

age, immunodeficiency, surgery, antibiotics, chemotherapy, prolonged stay

One major factor increasing nosocomial infection

failure to follow infection control measures

Main consequence of HAI

prolonged hospital stay and increased cost

Three principles of HAI prevention

exclude source, interrupt transmission, enhance host resistance

Role of Hospital Infection Control Committee (HICC)

formulate and update infection control policies

Most important measure to prevent HAI

hand washing

Universal precaution

all body fluids are treated as potentially infectious

Protective isolation

isolation used to protect immunocompromised patients

Source isolation

prevents spread of infection from infected patient to others

Recommended vaccine for healthcare workers

Hepatitis B vaccine